NCLEX : NCLEX

Study concepts, example questions & explanations for NCLEX

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Example Questions

Example Question #71 : Obstetrics And Gynecological Conditions

Which of the following conditions can be triggered by Rh incompatibility between mother and fetus? 

Possible Answers:

Hemolytic disease of the newborn

Hyperemesis gravidarum 

Postpartum hemorrhage

Gestational diabetes

Preeclampsia

Correct answer:

Hemolytic disease of the newborn

Explanation:

Of the conditions listed, the only one that is associated with Rh incompatibility between mother and fetus is hemolytic disease of the newborn (otherwise known as hemolytic disease of the fetus and newborn). In this condition, antibodies from the mother's blood attack the blood of the fetus. This is a major cause of fetal and newborn mortality and morbidity.

Example Question #1041 : Nclex

Which of the following maternal/fetal blood types can lead to hemolytic disease of the newborn?

Possible Answers:

Rh positive mother, Rh negative fetus

Rh positive mother, Rh positive fetus

Rh negative mother, Rh positive fetus

Rh negative mother, Rh negative fetus

Correct answer:

Rh negative mother, Rh positive fetus

Explanation:

Hemolytic disease of the newborn occurs when an Rh negative mother is carrying an Rh positive fetus. The mother must have previously carried an Rh positive fetus and become sensitized to Rh-D antigen during miscarriage, pregnancy (due to placental rupture), or during delivery. Then, during a second pregnancy, anti-RhD antibodies from the mother's immune system can cross the placenta and attack the blood cells of the fetus, causing hemolytic anemia. 

Example Question #1042 : Nclex

What treatment can prevent the development of sensitization to Rh-D antigen in an Rh negative mother carrying an Rh positive fetus?

Possible Answers:

Therapeutic abortion

Rh-D fetal serum injections

Short-course immunosuppressant treatment

Rho(D) immune globulin

Correct answer:

Rho(D) immune globulin

Explanation:

Rh sensitization can be prevented by treatment of an Rh negative mother with Rho(D) immunoglobulin at 28 weeks, then again within 72 hours of delivery. This is a solution of IgG antibody to Rh-D, which is able to destroy any fetal red blood cells that enter the mother's bloodstream before her own immune system is able to form develop a sensitization.

Example Question #1044 : Nclex

A nurse working in labor and delivery is caring for a client that has been diagnosed with an incompetent cervix. The client has been informed by the physician she is now at risk for a spontaneous abortion. The client asks the nurse about possible interventions. 

The nurse is aware the procedure performed for an incompetent cervix is called __________.

Possible Answers:

McReynold's procedure

tubal ligation

dilation and curettage

colporrhaphy

a Shirodkar procedure

Correct answer:

a Shirodkar procedure

Explanation:

A Shirodkar procedure involves sewing a suture in and around the cervix to hold it closed. This is usually performed within the first trimester and later removed when the risk of miscarriage has lessened. 

Example Question #1045 : Nclex

A pregnant woman at 43 weeks gestation is having labor augmented with oxytocin infusion. Which of the following best categorizes this particular drug?

Possible Answers:

Erythropoietin

Prolactin

Anti-diuretic hormone

Growth hormone

Thyroid-stimulating hormone

Correct answer:

Anti-diuretic hormone

Explanation:

Oxytocin is often used to help augment labor by inducing contractions. This hormone is naturally made in the body and works as an anti-diuretic hormone (thus promotes the excretion of water). In labor, this hormone also works to stimulate uterine contractiity.

Example Question #1042 : Nclex

You are the nurse taking care of a 76-year old female who complains of vaginal dryness that is occasionally painful during intercourse. She is diagnosed with vulvovaginal atrophy. Which of the following is the best initial treatment?

Possible Answers:

Topical estrogen

Diphenhydramine

Oxybutinin

Systemic estrogen

Propranolol

Correct answer:

Topical estrogen

Explanation:

The correct answer is "Topical estrogen." 

In a patient with atrophic vulvovaginitis, a condition that causes thinning of the vaginal and vulvar tissue, resulting in inflammation, diminished lubrication, and subsequent pain, the best initial treatment option if the condition is distressing to the patient is application of topical estrogen. Atrophic vulvovaginitis is a common condition in post-menopausal women as the level of circulating estrogen decreases, and therefore estrogen-mediated effects on female tissues are diminished. With the significant decrease in estrogen to the vagina and vulva, inflammatory and painful symptoms may occur, as in this patient. By applying a topical estrogen cream to the affected tissues, this allows the patient to supplement the estrogen that was lost following menopause, while not exposing the patient to the potentially negative effects (e.g. cardiovascular) of systemic estrogen supplementation.

Propranolol is a beta-adrenergic antagonist and has no role in the treatment of atrophic vulvovaginitis. 

Oxybutinin is an anti-cholinergic medication that is used to treat spastic bladder, among other conditions. It has no role in the treatment of atrophic vulvovaginitis. 

Diphenhydramine is an anti-histamine medication that has a wide variety of uses, but none known to treat atrophic vulvovaginitis.

Example Question #1041 : Nclex

You are the nurse taking care of a 28-year old G3P2 who is at 33 weeks gestation. She goes into labor, and the physician orders administration of a tocolytic medication. Which of the following medications is a tocolytic?

Possible Answers:

Furosemide

Sertraline

Lisinopril

Terbinafine

Terbutaline

Correct answer:

Terbutaline

Explanation:

The correct answer is "Terbutaline." This is the correct answer, as terbutaline, a beta-2-adrenergic agonist, is the only medication listed that has tocolytic, or labor-repressing (anti-contraction) properties. It is one of the most common medications used for tocolysis in pregnant women. Another commonly used tocolytic agent is nifedipine, a calcium-channel blocker.

The other choices are incorrect. Lisinopril is an angiotensin-converting enzyme inhibitor (ACE-I) that is commonly used to treat hypertension, among other conditions. It has no reported use as a tocolytic. Furosemide is a loop diuretic that is commonly used in the treatment of hypertension. It has no reported tocolytic properties. Sertraline is a selective serotonin reuptake inhibitor medication used to treat a number of conditions including major depressive disorder and generalized anxiety disorder, among others. Terbinafine is an allylamine anti-fungal medication used to treat conditions such as tinea corporis or tinea cruris. 

Example Question #1042 : Nclex

Basal body temperature is determined by __________.

Possible Answers:

taking the temperature in the evening

taking the temperature before rising

taking the temperature mid-morning

taking the temperature before bed

taking the temperature in the afternoon

Correct answer:

taking the temperature before rising

Explanation:

The basal body temperature is a method many women use to determine when ovulation occurs. To take a basal body temperature, one must use a basal thermometer (which is more sensitive) and take their body temperature before getting out of bed (or even sitting up) each morning. This method is utilized the best if a woman wakes up and takes her temperature at the same time daily.

Example Question #1043 : Nclex

A nursing student is participating in clinical practice on a labor and delivery unit. He is learning how to measure contractions. He knows that contractions are measured by frequency, duration, and intensity. Which timeframe correctly describes how the student should measure the frequency of contractions? 

Possible Answers:

The increment of the first contraction to the increment of the second

The acme of the first contraction to the acme of the second

The increment of the first contraction to the acme of the second

The increment of the first contraction to the decrement of the second

The increment of the first contraction to the decrement of the first

Correct answer:

The increment of the first contraction to the increment of the second

Explanation:

Increment is the beginning or rise of the contraction. Acme is the peak of the contraction. Decrement is the fall of the contraction. Frequency is measured from the beginning of one contraction to the beginning of another, so it should be measured from the increment of the first contraction to the increment of the second contraction.

Example Question #1043 : Nclex

While caring for a laboring patient, the nurse is called into the room because her patient felt a "gush" of fluid. Which of the following should be the nurse's next action?

Possible Answers:

Alert the physician

Change the sheets

Inform the mother of what she should expect next

Turn the mother to her right side

Assess fetal heart rate

Correct answer:

Assess fetal heart rate

Explanation:

The nurse must suspect rupture of the membranes (amniotic sac). Assess fetal heart rate if rupture of the membranes may have occurred. With rupture comes the potential for cord prolapse. Assess fetal heart rate for baseline variability. Marked variability may be cause for concern and the nurse should monitor the patient for signs of infection.

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